BANGOR, Maine — Unionized nurses at Eastern Maine Medical Center voted Thursday to authorize a strike if the hospital fails to better address their patient safety concerns, including “unsafe staffing.”

The registered nurses are working under a contract extended through June 18, after their original contract expired May 30, according to a news release from the Maine State Nurses Association/National Nurses Organizing Committee. The next bargaining session is scheduled for June 10, followed by another meeting June 17.

The union represents about 850 nurses at EMMC.

The nurses said the new contract must address “critical issues impacting patient safety,” to reduce injuries, infections and bedsores among patients treated at the hospital. Unionized nurses voted “overwhelmingly” to prepare to strike if “management continues to turn a blind eye to patient safety,” according to the release.

“As nurses, our first priority is our patients,” EMMC nurse Steve Akerley said in the release. “While we would always prefer to be providing care, at the bedside, the reason nurses voted to authorize a potential strike is because management is putting our patients’ lives and health in jeopardy. We cannot stand by and let that happen.”

In a statement, EMMC said the union’s vote does not mean a strike is imminent. A strike could occur only after the contract expires June 18 and the union gives the hospital 10 days’ notice.

“We are disappointed that we haven’t been able to reach an agreement,” Deb Sanford, EMMC’s vice president and chief nursing officer, said in the statement. “While we continue to negotiate, our focus remains on providing excellent patient care and serving the needs of those who rely on us every day.”

While negotiations have progressed somewhat, EMMC and the union “remain far apart” on many issues, including staffing ratios, which the hospital described as “a national agenda item the union is pushing at hospitals across the country without consideration for local issues.”

MSNA/NNOC is an affiliate of National Nurses United, which represents 190,000 registered nurses nationwide. The California Nurses Association founded National Nurses United as a national arm, potentially eyeing a bigger stage as it battled with Kaiser Permanente over staffing at the country’s eight-largest health system, according to Kaiser Health News.

California nurses have pushed Congress to pass legislation to establish staffing ratios of at least one nurse per every five patients.

Improved staffing would lead to better care, the Maine union argued. The nurses pointed to a study that found lower staffing ratios, matching those already mandated in California, are associated with fewer patient deaths and greater job satisfaction among nurses.

The union noted the Medicare program penalized EMMC for high rates of complications and infections. Medicare cut payments to EMMC, along with five other Maine hospitals, by 1 percent this fiscal year as part of the government’s nationwide crackdown on avoidable medical errors.

Sanford said nurse staffing plays no role in most of the indicators Medicare penalized EMMC for, including in critical care units where nurses tend to only one or two patients at a time. EMMC wasn’t fined for falls or bedsores, she said.

The Bangor hospital fared well on other safety report cards, earning straight A grades since 2012 from hospital watchdog The Leapfrog Group. Leapfrog awarded EMMC a perfect score for its nursing staffing.

Without a secure contract, the hospital has struggled to recruit and retain nurses, the union said. As of late May, 39 registered nurse positions remained open at EMMC.

The hospital plans to fill those positions, which include 23 jobs vacated by nurses who left EMMC or found other positions within the hospital, Sanford said. The hospital posted 15 positions for hire Tuesday, she said.

EMMC’s vacancy rate for RNs is 3.2 percent, just shy of a goal set by a magnet hospital program but much lower than the national average of 8.1 percent, she said.

EMMC has refused to set patient-nurse ratios, saying they rob the hospital of the flexibility to staff based on the needs of patients. The hospital’s approach takes into account the skills and experience of nurses on duty, the severity of patients’ conditions, as well as admissions and discharges, the hospital said in the statement. Patients receive care from teams that include not only registered nurses but also nurse techs, physicians, therapists and other health care professionals, according to EMMC.

Along with staffing, the union is negotiating with the hospital on wages, benefits and other working conditions. The union made no mention of pay in its news release, focusing instead on staffing and patient safety. But EMMC characterized compensation as another “main sticking point” in the negotiations, with the hospital and the union nowhere near agreement on wage increases and pay for working nights, weekends and holidays.

The nurses’ union seeks an 8 percent wage increase across the board, Sanford said.

“EMMC is committed to coming to an agreement that respects the important role nurses play in patient care, but we cannot accommodate the union’s significant wage demands,” the statement read.

EMMC nurses have walked the picket line before. Union members ratified a one-year contract in May 2011 after eight months of often contentious negotiations that included a strike, work stoppage and lockout, with threats of a second strike and lockout. Even after ratifying the last contract, nurses said staffing remained a problem.

That three-year contract granted the nurses raises of at least 7 percent and beefed up security at the hospital.

EMMC employs about 1,100 registered nurses, including 315 managers pool nurses who aren’t represented by the union.

Hospital officials said patient care will continue uninterrupted if the union decides to strike.

Jackie Farwell

I'm the health editor for the Bangor Daily News, a Bangor native, a UMaine grad, and a weekend crossword warrior. I never get sick of writing about Maine people, geeking out over health care data, and...